Facial Plastic Surgery Questions and Answers: Part 02

Question: Worried that correcting crooked nose will ruin aesthetically pleasing side?
Answer: When the nose is very crooked, there is a convex and a concave side. When straightening the crooked nose, osteotomies are placed in the nasal bones, and any dorsal hump is shaved down to make the nose symmetrical from both 3/4 views. You may also require a spreader graft composed cartilage placed on the concave side as well. The nose is a 3-dimensional structure, and rhinoplasty is performed in all 3 dimensions, so make sure the surgeon that you had chosen is a very experienced rhinoplasty surgeon. Look at that surgeon’s before and after Photo Gallery for crooked nose repair. 

Question: What can I fix to have a balanced face?
Answer: A full set of facial photographs from all angles and his chin neutral position are going to be required to make a determination about how best to proceed. A closed rhinoplasty can accomplish shaving down the dorsal hump, narrowing the bridgeline, refining the nasal tip, and preventing it from drooping down dynamically when smiling.

Question: Could I benefit for a small amount of chin lipo?
Answer: It’s important to understand that there are two compartments of fat in the neck, above and below the platysma muscle. Liposuction can only accomplish removal of the fat above the muscle, while a surgical neck lift is required to remove deposits below the muscle which also includes a platysma plasty to significantly improve the jawline. An in-person exam would be helpful.

Question: Am I a candidate for MyEllevate given the recovery time?
Answer: The limited photographs demonstrate a recessive chin profile, and fat deposits in your neck located both above and below the platysma muscle in your neck. Minimally invasive treatments cannot address those issues, and give minimal results, if anything. Consider placement of a small chin implant to augment your chin forward for better structural support for the soft tissues in the neck. Liposuction alone will only remove the fat deposits above the muscle and will only be partially effective. A neck lift procedure can accomplish removal of both compartments of fat in addition to a platysma plasty to significantly improve the jawline. No skin removal is required. Just a one-inch access incision underneath the chin. You can keep your beard to Camouflage the swelling after the procedure. No bandages or wraps are required after the surgery.

Question: Am I a candidate for facelift?
Answer: It’s important see a better set of photos including your neck to make a determination about how best to proceed. Limited photos did not even show Jowls present yet. 37 years of age is really young for a face neck lift. The goal of a facelift is too tighten loose facial and neck skin, tighten loose facial and neck muscles, lift the jowls and remove fat deposits in the neck which also includes a platysma plasty.

Question: Fat bags on corner of eyes and bleph recommendations?
Answer: There are three compartments of fat in the lower lids, and from this one limited photograph, you have herniated fat in the outermost lateral compartment. A better determination can be made while looking straight ahead into the camera and post another photo. In our practice, we remove these fat bags through a trans- conjunctival approach with the incision completely located on the inside of the eyelids. It is performed under a brief general anesthesia as an outpatient procedure.

Question: What type of Rhinoplasty is required?
Answer: You are going to your require a full rhinoplasty to de-project your nose. A closed rhinoplasty approach can accomplish your goals with all incisions incisions placed on the inside of the nose. The projection of your nose is not caused by the tip cartilages, it’s caused by your dorsal septum. Once the dorsal septum is shaved down, that will create an open roof deformity, which then requires osteotomies to placed in the nasal bones. 

Question: Can I shave down dorsal bump?
Answer: Your dorsal bump is composed of both bone and cartilage which must be shaved down. You’re going to require osteotomy’s placed in the nasal bones to close the open roof created from the hump removal itself. You will also need to reduce the hanging columella present. This is a full rhinoplasty, which can be performed by the closed technique. All the incisions are placed on the inside of the nose. We perform this procedure under general anesthesia by a board certified physician anesthesiologist for patient safety and comfort. 

Question: Would it be recommended to do rhinoplasty before eye surgery, or does it matter?
Answer: In our practice, we do rhinoplasty, eyelid surgery and necklifts separately or in combination on a routine basis. Look for a facial plastic surgeon who specializes in facial cosmetic surgery. Study their before after Photo Gallery to make sure that it is expensive with lots of results that look natural. You should be able to find a surgeon that can do all three procedures simultaneously under one anesthesia with one recovery period. It does not matter which procedure goes first or last if you going to separate them out in time.

Question: To fix my profile, do I need rhinoplasty or my jawline fixed?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, decreasing the overall projection of the nose, refining the bulbous nasal tip, and narrowing the bridge line with all the incisions placed on the inside of the nose. You also have a mild recessive chin, and a small chin implant can also improve the projection of your chin itself. Both procedures can be performed together under one anesthesia with one recovery.

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